PROJECT SUMMARY/ABSTRACT Background: A high percentage of Native Hawaiian and other Pacific Islander (NHPI) adults (37.4%) aged 18 and older did not see a doctor in the past year. This is the highest percentage among all racial groups. Furthermore, approximately one in eight NHPI adults (12%) are uninsured, a rate that is markedly lower than Whites. Federal reports historically struggle to capture data that could explain these phenomena. Hence, NHPI are insufficiently and incompletely represented in health statistics, access health services at lower rates, and are insured at lower rates than other racial and ethnic minority groups. This has implications for perpetuating adverse health conditions and disparities that are prevalent in this community (e.g., cardiovascular disease, hypertension, diabetes, heart disease, cancer, etc.). Objective: The overarching goal of this research is to improve and broaden our understanding of novel multi-level health determinants causing (1) low health service utilization rates and (2) low health insurance coverage rates of NHPIs, which are presently understudied health access disparities for Native Hawaiians and other Pacific Islanders in the U.S. Design: A closed access, cross-sectional Internet survey will be used to collect data. Participants will be recruited with announcements distributed nationwide via email to NHPI organizations, associations, and networks across the United States and social media. The proposed sample size is 300 NHPI adults aged 18 and older. Analysis: Latent profile analysis (LPA) will be conducted using Mplus 8 statistical software to examine whether different conceptually meaningful profiles of NHPI Islanders emerge based on levels of hypothesized individual (Depression, Anxiety and Perceived Stress), interpersonal (Medical Mistrust and Racial Discrimination), community (Cultural Efficacy and Pacific Connectedness and Belonging) and societal-levels (Religious Centrality and Perceived Societal Wellbeing) health determinants while accounting for demographic covariates. We will then test whether the resulting profiles had differential healthcare access rates (health service utilization and insurance coverage). LPA fits the purpose of this study, which is to determine distinct configurations (i.e., profiles) of potential individual, interpersonal, community and societal-level health determinants of healthcare access and to examine whether profiles differed in their health service utilization rates and insurance coverage rates. Latent profile analysis allows for the estimation of measurement error to improve accuracy of estimates. Significance: Findings will inform public policy and healthcare professionals about this severely underrepresented population in health research to eliminate excessively low levels of healthcare utilization and low insurance coverage rates among NHPI. The results could contribute to the development of culturally competent interventions for this underrepresented an...